Uworld5 Flashcards

1
Q

Post-operative patient with hypotension, jugular venous distension, and new-onset right bundle branch block

A

massive PE

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2
Q

What is AST/ALT ratio for nonalcoholic fatty liver disease?

A

less than 1

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3
Q

Crescendo-decrescendo systolic murmur along with left sternal border without carotid radiation is the description of the murmur present ?

A

hypertrophic obstructive cardiomyopathy

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4
Q

Metabolic change for persistent diarrhea

A

excess bicarbonate loss

metabolic acidosis

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5
Q

vomiting causes what metabolic changes?

A

metabolic alkalosis

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6
Q

How does H1 histamine receptor antagonists get rid of upper-airway cough syndrome

A

elimination of nasal discharge and cough

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7
Q

The single most important prognostic consideration in the treatment of patients with breast cancer >

A

Tumor burden which is based on TNM staging

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8
Q

how can you tell if the body is compensating for metabolic acidosis

A

PaCO2 = 1.5 (bicarb) + 8 +/- 2

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9
Q

Development of atrioventricular block in a patient with infective endocarditits should raise suspicion for

A

perivalvular abscess

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10
Q

Difference between perivalvular abscess and tricuspid valve endocardidits

A

perivalvular abscess: diastolic murmur, heard on full expiration
tricuspid: systolic murmur, heard on inspiration

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11
Q

The patient’s presentation with substernal discomfort, left-sided neck pain, diaphoresis, and dyspnea is consistent with what

A

acute coronary syndrome

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12
Q

fixed splitting of S2

A

atrial septal defect

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13
Q

recurrent, painless gastrointestinal bleeding?

A

angiodysplasia, often missed on colonoscopy

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14
Q

Rectangular, envelope-shaped crystals

A

ethylene glycol poisoning

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15
Q

persistant hypotension can lead to what in kidney

A

acute tubular necrosis

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16
Q

Best test of choice to confirm diagnosis for Zenker’s?

A

contrast esophagram

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17
Q

what should be suspected in unexplained congestive heart failure, proteinria, and left ventricular hypertrophy in the absence of a history of hypertension

A

amyloid cardiomyopathy

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18
Q

pneumonia causes what shunting in the lung

A

right-to-left intrapulmonary shunting

extreme form: V/Q mismatch

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19
Q

What is the next step for clinically obvious acute bacterial prostatitis?

A

mid-stream urine sample to help direct antiobiotic therapy

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20
Q

Next step in management for pulseless electrical activity

A

CPR!
IV access
Epinoephrine

Defibrillation does not play a role!

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21
Q

Next step for type A dissection?

A

CT angiography if patient is hemodynamically stable

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22
Q

treatment for bradycardia

A

atropine

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23
Q

what size kidney stone passes spontaneously

A

5mm

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24
Q

Calcium what help stabilize the cardiac membrane due to hyperkalemia

A

calcium chloride or calcium gluconate

Not calcium carbonate

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25
Q

what is anticoagulation therapy for Warfarin

A

Vitamin K

Prothrombin complex concentrate

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26
Q

What agent is used to reverse heparin

A

protamine sulfate

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27
Q

what type of dysfunction is more prominent in vascular dementia?

A

executive more than memory

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28
Q

What confirms the diagnosis of carpal tunnel syndrome

A

nerve conduction studies

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29
Q

What are some symptoms of cyanide toxicity

A
headache
confusion 
arrhythmias
flushing 
respiratory depression
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30
Q

In endemic countries, what is a common cause of constrictive pericarditis

A

tuberculosis

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31
Q

Pericardial calcifications indicates

A

constrictive pericardaritis

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32
Q

difference between SLE and viral arthritis

A

RA/SLE: less common, follows a chronic, protracted course

Viral: resolves spontaneously

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33
Q

Leydig cell tumors

A

estrogen production can be increased with secondary inhibition of LH and FSH

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34
Q

Seminonas

A

syncytiotrophlastic giant cells

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35
Q

Choriocarcinoma

A

increased serum beta-hCG concentration

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36
Q

Treatment for Wolff-Parkinson-white syndrome with A. fib with RVR?

A

Procainamide

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37
Q

what is pule ox for pericardial effusion

A

would not cause dramatic hypoxia

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38
Q

what are uncommon symptoms for mediastinal widening such as aortic dissection?

A

dyspnea and marked hyppoxia are uncommon

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39
Q

When is physical therapy recommended for back pain?

A

pain for 6-12 weeks or longer

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40
Q

Decreased breath sounds

Decreased tactile fremitus

A

pleural effusions

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41
Q

Increased breath sounds
Increased tactile fremitus
dullness to percussion

A

lung consolidation

42
Q

Isolated premature ventricular beats in patients with normal ejection, do they syncope?

A

no

43
Q

X-ray for bronchiectasis

A

dilated conducting airways

44
Q

acid base for vomiting and diuresis

A

increased HCO3-

metabolic alkalosis

45
Q

first step in management for oropharyngeal dysphagia

A

barium swallow

46
Q

is there an increase in jugular venous pressure in inferior vena cava obstruction

A

no

47
Q
Progressive peripheral edema
ascites
elevated jugular venous pressure 
pericardial knock (middiastolic sound)
pericardial calcifications on x-ray
A

constrictive pericarditits

48
Q

When do you get an MRI of back pain

A

neurologic deficits
cauda equina
suspected epidural abscess

49
Q

When do you get an x-ray of back pain

A
malignancy 
inflammatory markers ( ESR elevated)
50
Q

Clinical/laboratory features of common bile duct obstruction

A

obstructive jaundince with severe icterus and very high alkaline phosphatase levels.

51
Q

what value constitutes CO2 narcosis

A

PaCO2 >60 mmHg

52
Q

Acute-on-chronic hypercarbia COPD and chronic CO2 retention

A

Chronic: normal pH and high bicarb
acute: acidic pH and low bicarb

53
Q

What kind of rash does disseminated gonococcemia cause

A

vesiopustular rash

54
Q

What type of rash does interstitial nephritis cause. urine

A

macuopapular rash. no WBC

55
Q

When do symptoms typically occur for allergic interstitial nephritis. urine

A

5 days to several weeks after use of offending agent. WBC and eosinphilia present

56
Q

When do you give activated charcoal for acetominophen intoxication

A

within 4 hours of ingestion

57
Q

Treatment for diphenhydramine overdose

A

physostigmine –> cholinesterase inhibitor

58
Q

clinical features of arsenic poisoning

A

sensorimotor neuropahty
Pancytopenia
mild transaminase elevation
hyper/hypopigmentation hyperkeraotic

59
Q

Clinical features of lead

A

Sensorimotor neuropathy
GI complaints
anemia

60
Q

Clinical features of intermittent porphyria

A

Patchy sensorimotor neuropathy
Autonomic dysfunctino
GI complaints
Anemia

61
Q

Do pupils contract on benzodiazepine overdose

A

no

62
Q

Carboxyhemoglobin level determines what

A

carbon dioxide poisoning

63
Q

Clinical features of methemoglobinemia

A

cyanosis and bluish discoloration of skin and mucous membranes

64
Q

Bitter almond breath

A

cyanide poisoning

65
Q

What is the next step in management for sodium or potassium hydroxide (lye) caustic ingestion

A

endoscopy within 24 hours

66
Q

Antidote for cyanide poisoning

A

Hyroxycobalamin
sodium thiosulfate
nitrates (induce methemoglobinemia)

67
Q

carboxyhemoglobinemia is what colored skin?

A

pinkish-red

68
Q

How do you treat methemolgobinemia

A

methylene blue
oxgyen
vitamin C

69
Q

how do you rewarm someone with frostbite

A

hot water NOT hot air

70
Q

inadequate fluid and salt repalcement. CNS dysfunction is not present

A

heat exhaustion

71
Q

healthy person undergoing condition in extreme heat and humidty. CNS symptoms

A

exertional heat stroke

72
Q

3 categories for lead poisoning in adults

A

GI
neurological
hematologic

73
Q

Next step for foreign bodies or cuts/scratches of the eye

A

obtaining medical care is first priority

74
Q

bowl sounds for opioid intoxication

A

decreased bowel sounds

constipation

75
Q

treatment for ethylene glycol overdose

A

fomepizole and ethanol to inhibit alcohol dehydrogenase

sodium bicarbonate to alleviate acidosis

76
Q

Chalazion

A

lid discomfort. Hard, painless lid nodule

77
Q

Hordeolum

A

abscess located over the upper or lower lid.

red, tender swelling over eyelid

78
Q

Amaurosis fugax

A

atheroemboli from carotid arteries

temporary vision loss

79
Q

What type of conjunctivitis is bilateral

A

allergic

80
Q

Endopthalmitis

A

within 6 weeks of surgery
Pain and decreased visual acuity
Swollen eye lids and conjunctiva, hypopyon, corneal edema, infection
“left eye reveals swollen eyelid, edematous conjunctive, and exudates in the anterior chamber.”

81
Q

Uveitis

A

moderate pain and blurred vision

pupil is constricted

82
Q

gold standard for diagnosis for acute angle-closure glaucoma

A

Gonioscopy

83
Q

Dendriform corneal ulcers

A

herpes zoster ophthalmicus

84
Q

Preseptal cellutitis

treatment?

A

infection of eyelid anterior to orbital septum

oral doxycycline

85
Q

HSV and VZV eye infection

A

pain
keratitis
fundoscopic findings: peripheral pale lesions and central retinal necrosis

86
Q

CMV eye

A

painless

87
Q

Most common pathogen for keratitis

A

pseudomonas

88
Q

patients who report straight grid lines that appear curved

A

macular degeneration

89
Q

Presbyopia

A

difficulty with near vision

90
Q

Difference between presbyopia and astigmatism

A

presbyopia: abnormal lens elasticity
astigmatism: corneal shape

91
Q

For ocular trauma, what is the initial step and second step

A

Initial pen light

Fluorescein examination

92
Q

Fundoscopy exam for macular degeneration

A

drusen spots

93
Q

Fundoscopy exam for central retinal artery occlusion

A

cherry red spot

94
Q

Treatment of central retinal artery occlusion

A

ocular message and high-flow oxygen administration

95
Q

curtain descending over visual field

A

retinal detatchment

amaurosis fugax

96
Q

Gentamicin side effect

A

vestibular injury without significant ototoxicty

97
Q

Aminoglycoside side effect

A

ototoxicity

98
Q

Upper motor symtoms

A

spasticity
bulbar symptoms
hyperreflexia
babinski

99
Q

Lower motor symtpoms

A

fasciculations

atrophied hand musculature

100
Q

Anterior cord syndrome

A

loss of motor function

loss of pain and temperature